Patient Safety and the Culture of Cover-Up

An interesting article was written by George Lundberg titled “A culture of cover-up has slowed the patient safety movement” on December 1, 2012, on located at

In the article Dr. Lundberg says

“Promoting patient safety, preventing medical error, preventing physician error, preventing errors in diagnosis, preventing nurse error, preventing surgical error, preventing communication error, preventing health illiteracy error, preventing errors from language barriers, preventing laboratory error, preventing computer error, preventing patient mix-ups, preventing right and left side of body mix-ups, preventing mistakes, since mistakes are the stepping stones to failure.

Recognizing human frailty, recognizing physician humanity, recognizing system fallibility, owning up to problems, eliminating cover-up, acting out professionalism, recognizing that professionalism means self governance, individually and as groups.

Self criticism, peer criticism, a culture of peer review, honesty, truth, disclosure, fairness, and negotiated settlements.

Objective evaluation and commitment to quality. Quality improvement by preventing error. Systematic error, systematic prevention of error. An error caught before an action is taken based upon that error is, in effect, not an error.

These are the fundamental truths that the patient safety movement is all about.”

Dr. Lundberg later says

“However, sad to say, improvement in documented actual patient safety has lagged grotesquely. Part of that retardation can be blamed upon a continuing culture of cover-up.”

Dr. Lundberg mentions a program recently explored by the Agency for Healthcare Research and Quality (AHRQ). I have discussed AHRQ before see for example Tips to Prevent Medical Errors – AHRQ.

As outlined in the article “AHRQ Seeks To Help Patients Report Adverse Medical Events” from September 24, 2012, located over at The AHRQ is currently looking into a system that would allow patients to report such things as medical errors and harms to the federal government. This is an interesting development, however, the issue of malpractice liability needs to be addressed. Certainly physicians have concerns about being sued if a patient suffers a potential error.

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